Association of depression screening with diagnostic and treatment-related outcomes among youth

Background and Objectives The goals of depression screening, which is universally recommended in primary care settings in the U.S., are to identify adolescents with depression and connect them to treatment. However, little is known about how depression screening affects the likelihood of being diagnosed with a mental disorder or accessing mental health care over time. Methods This longitudinal cohort study used insurance claims data from 57,732 adolescents who had at least one routine well-visit between 2014 and 2017. Using propensity score matching, we compared adolescents who were screened for depression to similar adolescents who were not screened for depression during the well-visit. Diagnostic and treatment-related outcomes were examined over 6-month follow-up and included depression diagnoses, mood-related diagnoses, antidepressant prescriptions, any mental health-related prescriptions, and psychotherapy. We also examined heterogeneity of associations by sex. Results Compared to adolescents who were not screened for depression, adolescents screened for depression were 30% more likely to be diagnosed with depression (RR=1.30, 95% CI=1.11-1.52) and 17% more likely to receive a mood-related diagnosis (RR=1.17, 95% CI=1.08-1.27), but were not more likely to be treated with an antidepressant prescription (RR=1.11, 95% CI=0.82-1.51), any mental health prescription (RR=1.15, 95% CI=0.87-1.53), or psychotherapy (RR=1.13, 95% CI=0.98-1.31). In general, associations were stronger among females. Conclusions Adolescents who were screened for depression during a well-visit were more likely to receive a diagnosis of depression or a mood-related disorder in the six months following screening. Future research should explore methods for increasing access to treatment and treatment uptake following screening.

Download Full-text

Pathways to Mental Health–Related Treatment Among Caregiving Spouses

Innovation in Aging ◽

10.1093/geroni/igaa057.1151 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 358-358

Author(s):

Hyojin Choi ◽

Kristin Litzelman ◽

Molly Maher ◽

Autumn Harnish

Keyword(s):

Mental Health ◽

Primary Care ◽

Mental Healthcare ◽

Health Condition ◽

Future Research ◽

Provider Type ◽

Hospital Emergency Room ◽

Health Related ◽

Nationally Representative

Abstract Spouses of cancer survivors are 33% less likely to receive guideline-concordant depression treatment than other married adults. However, depression is only one of many manifestations of psychological distress for caregivers. This exploratory study sought to assess the paths by which caregivers access mental health-related treatment. Using nationally representative data from the Medical Expenditures Panel Survey, we assessed the proportion of caregivers who received a mental health-related prescription or psychotherapy visit across care settings (office based versus outpatient hospital, emergency room, or inpatient visit), provider type (psychiatric, primary care, other specialty, or other), and visit purpose (regular checkup, diagnosis and treatment, follow-up, psychotherapy, other). In addition, we assessed the health condition(s) associated with the treatment. The findings indicate that a plurality of caregivers accessed mental health-related treatment through an office-based visit (90%) with a primary care provider (47%). A minority accessed this care through a psychologist or psychiatrist (11%) or a physician with another specialty (12%) or other provider types. Nearly a third accessed treatment as part of a regular check-up (32%). These patterns did not differ from the general population after controlling for sociodemographic characteristics. Interestingly, mental health-related treatments were associated with a mental health diagnosis in only a minority of caregivers. The findings confirm the importance of regular primary care as a door way to mental healthcare, and highlight the range of potential paths to care. Future research will examine the correlates of accessing care across path types.

Download Full-text

Intimate Partner Violence Among Persons With Mental Health-Related Disabilities in Canada

Journal of Interpersonal Violence ◽

10.1177/0886260520912589 ◽

2020 ◽

pp. 088626052091258

Author(s):

Douglas A. Brownridge ◽

Tamara Taillieu ◽

Marcelo L. Urquia ◽

Alexandra Lysova ◽

Ko Ling Chan ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Intimate Partner Violence ◽

Partner Violence ◽

General Social Survey ◽

Intimate Partner ◽

Elevated Risk ◽

Future Research ◽

Health Related ◽

Nationally Representative

This study examined the elevated risk of intimate partner violence (IPV) among persons with mental health-related disabilities (MH-RD) and the extent to which known risk factors accounted for this phenomenon. Data were drawn from a nationally representative sample of 33,127 Canadians collected in 2014 as part of Statistics Canada’s General Social Survey. Results showed that respondents with MH-RD had more than three-fold increased odds of both overall and severe IPV victimization. Although females were more likely to possess a MH-RD, males and females with MH-RD reported similarly elevated odds of IPV victimization. Risk factors that contributed to a significant reduction in elevated odds of IPV for respondents with MH-RD were child maltreatment (CM), respondents’ nonprescription drug abuse, and perpetrators’ jealous, monitoring, and socially isolating behaviors. The inability to test additional risk factors and bidirectionality in the relationship between MH-RD and IPV may have contributed to the failure to fully account for these respondents’ elevated odds of IPV. Future research is needed to understand the complex mechanisms contributing to the elevated risk of IPV and enhance prevention and intervention strategies for this underresearched and underserved vulnerable population.

Download Full-text

Getting a Grip on My Depression: How Latina Adolescents Experience, Self-Manage, and Seek Treatment for Depressive Symptoms

Qualitative Health Research ◽

10.1177/1049732319831043 ◽

2019 ◽

Vol 29 (12) ◽

pp. 1725-1738

Author(s):

Allison McCord Stafford ◽

Matthew C. Aalsma ◽

Silvia Bigatti ◽

Ukamaka Oruche ◽

Claire Burke Draucker

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Young Women ◽

Peer Groups ◽

Constructivist Grounded Theory ◽

Female Adolescents ◽

Future Research ◽

Community Settings ◽

Latina Adolescents ◽

To Receive

Latina (female) adolescents are more likely to experience depressive symptoms and less likely to receive mental health services than their non-Latina White peers. We aimed to develop a framework that explains how Latina adolescents experience, self-manage, and seek treatment for depressive symptoms. Latina young women ( n = 25, M age = 16.8 years) who experienced depressive symptoms during adolescence were recruited from clinical and community settings and interviewed about experiences with depressive symptoms. The framework was developed using constructivist grounded theory methods. Participants experienced a psychosocial problem that we labeled being overburdened and becoming depressed. They responded to this problem through a five-phase psychosocial process that we labeled Getting a Grip on My Depression. Family members, peer groups, and mainstream authorities were influential in how participants experienced these phases. Future research should further develop this framework in diverse samples of Latino/a youth. Clinicians can use this framework in discussions with Latina adolescents about depressive symptoms.

Download Full-text

Empirically Supported Psychological Treatments: Cognitive Processing Therapy

The Oxford Handbook of Traumatic Stress Disorders ◽

10.1093/oxfordhb/9780195399066.013.0030 ◽

2012 ◽

pp. 438-448

Author(s):

Kathleen M. Chard ◽

Jennifer Schuster Wachen ◽

Patricia A. Resick

Keyword(s):

Mental Health ◽

Cognitive Processing ◽

Treatment Effectiveness ◽

Future Research ◽

Cognitive Processing Therapy ◽

Institute Of Medicine ◽

Psychological Treatments ◽

Empirically Supported ◽

Health Related ◽

Underlying Mechanisms

Cognitive Processing Therapy (CPT) has been recognized by the Institute of Medicine (2007) as one of the most effective treatments for PTSD. This chapter provides a brief overview of the CPT session content, the underlying mechanisms of the therapy, a review of the empirically based literature outlining the treatment effectiveness, limitations of the therapy, and areas of future research. In addition, the authors discuss the utility of the various versions of CPT, including cognitive only (CPT-C), group, individual, and combination. Further the research supporting the effectiveness of CPT for treating PTSD related to a variety of traumas, (e.g., combat, child abuse, and rape) and the significant impact CPT can have in areas of mental health related to PTSD (e.g., anger, guilt, social functioning) are described.

Download Full-text

Profiling Commenters on Mental Health–Related Online Forums: A Methodological Example Focusing on Eating Disorder–Related Commenters

JMIR Mental Health ◽

10.2196/12555 ◽

2019 ◽

Vol 6 (4) ◽

pp. e12555 ◽

Cited By ~ 5

Author(s):

Duncan McCaig ◽

Mark T Elliott ◽

Cynthia SQ Siew ◽

Lukasz Walasek ◽

Caroline Meyer

Keyword(s):

Mental Health ◽

Eating Disorder ◽

Network Analysis ◽

Community Detection ◽

The Body ◽

Future Research ◽

Psychological Interventions ◽

Online Forums ◽

Web Based ◽

Health Related

Background Understanding the characteristics of commenters on mental health–related online forums is vital for the development of effective psychological interventions in these communities. The way in which commenters interact can enhance our understanding of their characteristics. Objective Using eating disorder–related (EDR) forums as an example, this study detailed a methodology that aimed to determine subtypes of mental health–related forums and profile their commenters based on the other forums to which they contributed. Methods The researchers identified all public EDR forums (with ≥500 contributing commenters between March 2017 and February 2018) on a large Web-based discussion platform (Reddit). A mixed-methods approach comprising network analysis with community detection, text mining, and manual review identified subtypes of EDR forums. For each subtype, another network analysis with community detection was conducted using the EDR forum commenter overlap between 50 forums on which the commenters also commented. The topics of forums in each detected community were then manually reviewed to identify the shared interests of each subtype of EDR forum commenters. Results Six subtypes of EDR forums were identified, to which 14,024 commenters had contributed. The results focus on 2 subtypes—proeating disorder and thinspiration—and communities of commenters within both subtypes. Within the proeating disorder subtype, 3 communities of commenters were detected that related to the body and eating, mental health, and women, appearance, and mixed topics. With regard to the thinspiration group, 78.17% (849/1086) of commenters had also commented on pornographic forums and 16.66% (181/1086) had contributed to proeating disorder forums. Conclusions The article exemplifies a methodology that provides insight into subtypes of mental health–related forums and the characteristics of their commenters. The findings have implications for future research and Web-based psychological interventions. With the publicly available data and code provided, researchers can easily reproduce the analyses or utilize the methodology to investigate other mental health–related forums.

Download Full-text

The association between mental health and physical fitness in Norwegian adolescents

10.21203/rs.2.21851/v1 ◽

2020 ◽

Author(s):

Andreas Åvitsland ◽

Eva Leibinger ◽

Tommy Haugen ◽

Øystein Lerum ◽

Runar Barstad Solberg ◽

...

Keyword(s):

Mental Health ◽

Body Composition ◽

Physical Fitness ◽

Cardiorespiratory Fitness ◽

Muscular Strength ◽

Future Research ◽

Health Related ◽

Strengths And Difficulties ◽

Adjusted Model ◽

The Relationship

Abstract Background: Studies indicate that cardiorespiratory fitness, muscular strength and body composition are associated with mental health. However, research is scarce concerning this relationship in young adolescents in general and non-existent in Norwegian populations specifically. The aim of the study was to examine the relationship between different health-related aspects of physical fitness and self-reported mental health in Norwegian adolescents. Methods: Participants from four regions of Norway (n = 1486; mean age = 13.9; girls = 50.6%) completed the Strengths and Difficulties Questionnaire, and were measured for cardiorespiratory fitness, muscular strength and body composition. Linear mixed effects models were conducted to assess the associations between the health-related aspects of physical fitness and the total difficulties score of the questionnaire. Results: Body composition was not associated with total difficulties score. Muscular strength independently was associated with total difficulties score, but when all independent variables were entered in the fully adjusted model, only cardiorespiratory fitness was associated with total difficulties score. School clusters were included as random effects and all models were controlled for sex, socioeconomic status and birthplace (domestic or foreign). Conclusions: A small but significant negative association between cardiorespiratory fitness and total difficulties score indicated that higher cardiorespiratory fitness predicted better mental health in Norwegian adolescents. The results suggest that muscular strength is not associated with mental health in adolescents, when controlling for cardiorespiratory fitness. Future research on how exercise affects mental health should investigate whether there is a greater effect for participants who improve their cardiorespiratory fitness.

Download Full-text

Utilisation patterns of privately funded mental health services in Australia

Journal of Health Organization and Management ◽

10.1108/jhom-02-2018-0062 ◽

2019 ◽

Vol 33 (1) ◽

pp. 5-17

Author(s):

Joanna Khoo ◽

Helen Hasan ◽

Kathy Eagar

Keyword(s):

Mental Health ◽

Health Insurance ◽

Health Service ◽

Private Health Insurance ◽

Claims Data ◽

Service Utilisation ◽

Insurance Claims ◽

Content Type ◽

Health Related ◽

Insurance Claims Data

Purpose The purpose of this paper is twofold: first, to present patient-level utilisation patterns of hospital-based mental health services funded by private health insurers; and second, to examine the implications of the findings for planning and delivering private mental health services in Australia. Design/methodology/approach Analysing private health insurance claims data, this study compares differences in demographic and hospital utilisation characteristics of 3,209 patients from 13 private health insurance funds with claims for mental health-related hospitalisations and 233,701 patients with claims for other types of hospitalisations for the period May 2014 to April 2016. Average number of overnight admissions, length of stay and per patient insurer costs are presented for each group, along with overnight admissions vs same-day visits and repeat services within a 28-day period following hospitalisation. Challenges in analysing and interpreting insurance claims data to better understand private mental health service utilisation are discussed. Findings Patients with claims for mental health-related hospitalisations are more likely to be female (62.0 per cent compared to 55.8 per cent), and are significantly younger than patients with claims for other types of hospitalisations (32.6 per cent of patients aged 55 years and over compared to 57.1 per cent). Patients with claims for mental health-related hospitalisations have significantly higher levels of service utilisation than the group with claims for other types of hospitalisations with a mean length of stay per overnight admission of 15.0 days (SD=14.1), a mean of 1.3 overnight admissions annually (SD=1.2) and mean hospital costs paid by the insurer of $13,192 per patient (SD=13,457) compared to 4.6 days (SD=7.3), 0.8 admissions (SD=0.6) and $2,065 per patient (SD=4,346), respectively, for patients with claims for other types of hospitalisations. More than half of patients with claims for mental health-related hospitalisations only claim for overnight admissions. However, the findings are difficult to interpret due to the limited information collected in insurance claims data. Practical implications This study shows the challenges of understanding utilisation patterns with one data source. Analysing insurance claims reveals information on mental health-related hospitalisations but information on community-based care is lacking due to the regulated role of the private health insurance sector in Australia. For mental health conditions, and other chronic health conditions, multiple data sources need to be integrated to build a comprehensive picture of health service use as care tends to be provided in multiple settings by different medical and allied health professionals. Originality/value This study contributes in two areas: patient-level trends in hospital-based mental health service utilisation claimed on private health insurance in Australia have not been previously reported. Additionally, as the amount of data routinely collected in health care settings increases, the study findings demonstrate that it is important to assess the quality of these data sources for understanding service utilisation.

Download Full-text

Public Stigma on Depression Comorbid with Diabetes: A Vignette-Method Study in China

10.21203/rs.3.rs-1115277/v1 ◽

2021 ◽

Author(s):

Patrick Leung ◽

Robin E. Gearing ◽

Wanzhen Chen ◽

Monit Cheung ◽

Kathryne B. Brewer ◽

...

Keyword(s):

Mental Health ◽

Public Perception ◽

Community Support ◽

Future Research ◽

Mental Health Stigma ◽

Public Stigma ◽

The Public ◽

Health Related ◽

And Gender ◽

The Impact

Abstract Background: Depression and diabetes are common illnesses affecting individuals with health challenges and family stress. Research suggested stigma-reduction interventions for families facing health-related stressors. This study examined factors predicting public stigma on depression alone or comorbid with diabetes. Methods: In Shanghai, China, consented respondents to a community-based survey read one of four vignettes varied by depression types and gender of the Vignette Subject (VS). This vignette method measures each respondent’s Individualized Public Stigma score, attitude toward the subject’s family with the Devaluation of Consumer’s Families score, and problem seriousness leading to stress. Results: 125 respondents expressed views on depression or diabetes-associated depression via their answers to a randomly assigned vignette. Results show significant associations with Individualized Public Stigma when entering the regression model with five variables: problem seriousness, knowing someone with a mental health problem, subject’s gender, attitude toward the subject’s family, and depression comorbid with diabetes. Regression statistics showed that a person’s Individualized Public Stigma scores could be predicted by two of these variables: perceived problem seriousness and sympathy toward the affected family. Yet, comorbidity with diabetes was not a significant predictor of stigma. Conclusions: This study concludes that the cultural value toward community support could be an educational means to help the public realize the importance of protecting the families affected by mental health stigma. Applying this theory in action, practitioners must assess how self-stigmatization interfaces with the public perception of the patient's family. In addition, when people have a highly sympathetic attitude toward the patient’s family and perceive the presenting problem as severe, they must be aware of the impact of individualized stigma on the patient. Future research must focus on these cultural perspectives to support early anti-stigma interventions.

Download Full-text

Profiling Commenters on Mental Health–Related Online Forums: A Methodological Example Focusing on Eating Disorder–Related Commenters (Preprint)

10.2196/preprints.12555 ◽

2018 ◽

Author(s):

Duncan McCaig ◽

Mark T Elliott ◽

Cynthia SQ Siew ◽

Lukasz Walasek ◽

Caroline Meyer

Keyword(s):

Mental Health ◽

Eating Disorder ◽

Network Analysis ◽

Community Detection ◽

The Body ◽

Future Research ◽

Psychological Interventions ◽

Online Forums ◽

Web Based ◽

Health Related

BACKGROUND Understanding the characteristics of commenters on mental health–related online forums is vital for the development of effective psychological interventions in these communities. The way in which commenters interact can enhance our understanding of their characteristics. OBJECTIVE Using eating disorder–related (EDR) forums as an example, this study detailed a methodology that aimed to determine subtypes of mental health–related forums and profile their commenters based on the other forums to which they contributed. METHODS The researchers identified all public EDR forums (with ≥500 contributing commenters between March 2017 and February 2018) on a large Web-based discussion platform (Reddit). A mixed-methods approach comprising network analysis with community detection, text mining, and manual review identified subtypes of EDR forums. For each subtype, another network analysis with community detection was conducted using the EDR forum commenter overlap between 50 forums on which the commenters also commented. The topics of forums in each detected community were then manually reviewed to identify the shared interests of each subtype of EDR forum commenters. RESULTS Six subtypes of EDR forums were identified, to which 14,024 commenters had contributed. The results focus on 2 subtypes—proeating disorder and thinspiration—and communities of commenters within both subtypes. Within the proeating disorder subtype, 3 communities of commenters were detected that related to the body and eating, mental health, and women, appearance, and mixed topics. With regard to the thinspiration group, 78.17% (849/1086) of commenters had also commented on pornographic forums and 16.66% (181/1086) had contributed to proeating disorder forums. CONCLUSIONS The article exemplifies a methodology that provides insight into subtypes of mental health–related forums and the characteristics of their commenters. The findings have implications for future research and Web-based psychological interventions. With the publicly available data and code provided, researchers can easily reproduce the analyses or utilize the methodology to investigate other mental health–related forums.

Download Full-text

Experience of stigmatization in children receiving inpatient and outpatient mental health treatment: a longitudinal study

European Child & Adolescent Psychiatry ◽

10.1007/s00787-021-01904-5 ◽

2021 ◽

Author(s):

Anya Kaushik ◽

Efstathios Papachristou ◽

Laurence Telesia ◽

Danai Dima ◽

Sandra Fewings ◽

...

Keyword(s):

Mental Health ◽

Mental Health Treatment ◽

Correlation Coefficients ◽

Change Score ◽

Future Research ◽

Global Functioning ◽

Outpatient Mental Health ◽

Related Stigma ◽

Health Related ◽

Long Term Impact

AbstractMental health-related stigma is poorly understood, and minimal research has focused on the experience of stigma from children’s perspectives. We sought to investigate whether children treated as inpatients and outpatients had different experiences of stigma over time and whether stigma is linked to global functioning cross-sectionally and longitudinally. Children, aged 8–12 years, receiving treatment within a national specialist mental health inpatient unit were matched for age, gender and diagnosis with children receiving outpatient treatment (N = 64). Validated measures of stigma, global functioning and symptom severity were collected at the start of treatment and upon discharge from the ward for inpatients, and a similar timeframe for their individually matched outpatients. Latent change score models and partial correlation coefficients were employed to test our hypotheses. No differences in most aspects of stigma between children treated as inpatients and outpatients were observed, except for personal rejection at baseline and self-stigma at follow-up favouring outpatients. A reduction in stigma was observed in societal devaluation, personal rejection and secrecy for inpatients, and self-stigma and secrecy for outpatients between the two assessments. Societal devaluation declined at a higher rate among inpatients compared to outpatients, albeit reductions in stigma were comparable for all remaining measures. No association was found between the change in stigma and change in global functioning. Future research may offer further insights into the development and maintenance of stigma and identify key targets for anti-stigma interventions to reduce its long-term impact.

Download Full-text