scholarly journals Population heterogeneity in associations between hormonal contraception and antidepressant use in Sweden: a prospective cohort study applying intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA)

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e049553
Author(s):  
Sofia Zettermark ◽  
Kani Khalaf ◽  
Raquel Perez-Vicente ◽  
George Leckie ◽  
Diana Mulinari ◽  
...  

ObjectivesFrom a reproductive justice framework, we aimed to investigate how a possible association between hormonal contraceptive (HC) and antidepressants use (as a proxy for depression) is distributed across intersectional strata in the population. We aimed to visualise how intersecting power dynamics may operate in combination with HC use to increase or decrease subsequent use of antidepressants. Our main hypothesis was that the previously observed association between HC and antidepressants use would vary between strata, being more pronounced in more oppressed intersectional contexts. For this purpose, we applied an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy approach.DesignObservational prospective cohort study using record linkage of national Swedish registers.SettingThe population of Sweden.ParticipantsAll 915 954 women aged 12–30 residing in Sweden 2010, without a recent pregnancy and alive during the individual 1-year follow-up.Primary outcome measureUse of any antidepressant, meaning being dispensed at least one antidepressant (ATC: N06A) during follow-up.ResultsPreviously mentally healthy HC users had an OR of 1.79 for use of antidepressants compared with non-users, whereas this number was 1.28 for women with previous mental health issues. The highest antidepressant use were uniformly found in strata with previous mental health issues, with highest usage in women aged 24–30 with no immigrant background, low income and HC use (51.4%). The largest difference in antidepressant use between HC users and non-users was found in teenagers, and in adult women of immigrant background with low income. Of the total individual variance in the latent propensity of using antidepressant 9.01% (healthy) and 8.16% (with previous mental health issues) was found at the intersectional stratum level.ConclusionsOur study suggests teenagers and women with immigrant background and low income could be more sensitive to mood effects of HC, a heterogeneity important to consider moving forward.

2021 ◽  
Vol 3 ◽  
Author(s):  
Amber L. Pearson ◽  
Teresa Horton ◽  
Karin A. Pfeiffer ◽  
Rachel Buxton ◽  
Joseph Gardiner ◽  
...  

Despite a growing number of research outputs on the importance of nature contact during the COVID-19 pandemic, we know of no longitudinal research conducted prior to and during the pandemic among low-income and minority ethnicity populations, i.e., those that might be most affected. Furthermore, we have scant information about how and to what degree contact with nature might protect mental health or mitigate worsening of mental health during the pandemic. We filled these gaps using a subset of a longitudinal study of n = 86 individuals in low-income, predominantly African American, neighborhoods in Detroit, MI, USA. The study addressed the following research questions: (1) did self-reported use and perceived value of nature change during, vs. prior to, the pandemic; (2) did perceived access to outdoor spaces buffer people against mental health issues such as stress, anxiety and depression symptoms; or (3) did objectively measured quality of nature views from home buffer people against mental health issues, taking into account relevant covariates and pandemic experiences (e.g., loss of employment, death of a friend/relative)? While attitudes to nature improved slightly from pre- to during the pandemic, we also observed significant decreases in most types of outdoor physical activity and passive enjoyment of nature (e.g., smelling plants/rain). We found a positive association between visibility of greenspace and perceived stress and anxiety, which not only contradicts previous research findings, but was especially surprising given that overall there was a decrease in perceived stress from 2019–2020. We did not detect associations between perceived access/use of nature and mental health. However, higher depressive symptoms were associated with exposure to more COVID-19-related stressors (lost employment, death of friends from COVID-19, etc.). Taken together, our results indicate that COVID-19 may serve to prolong or exacerbate mental health issues, rather than create them, in this population and that low quality greenspace may perhaps limit the ability for nature view to buffer mental health during the pandemic.


2020 ◽  
Vol 09 (04) ◽  
pp. 186-192
Author(s):  
Sarah A. Healy ◽  
Tadeu A. Fantaneanu ◽  
Sharon Whiting

AbstractMental health issues become especially problematic when adolescents with epilepsy are preparing to transition from pediatric to adult care. Consistent with guidelines, a transition clinic with ongoing mental health assessment was created, providing treatment to patients scoring in the moderate severity range or higher. In order to examine the effectiveness of our epilepsy transition clinic and the impact of mental health in transition-aged adolescents, baseline and one-year follow-up data were compared in 36 participants (M = 15.82 years, 24 males). Results showed that the majority of participants had improved or comparable mental health scores at follow-up. Furthermore, participants who met threshold for mental health treatment had significantly improved mental health (t = 3.19, p = 0.015), while those who did not showed worsened mental health (t =  − 2.50, p = 0.019). Looking specifically at mental health impact, those with worsened mental health showed significantly worsened quality of life (t = 3.35, p = 0.012). Furthermore, those without mental health issues showed improved transition skills (t =  − 3.86, p = 0.002), while those with mental health issues did not. Results suggest that the transition clinic is effective in helping transition-aged adolescents with their mental health. Additionally, findings suggest that addressing these mental health issues are essential to ensuring successful transitions and the best outcomes in these patients.


2021 ◽  
Author(s):  
Caitlin Joy Davey

First Nations, Inuit and Métis youth in Canada report higher rates of mental health (i.e., depression, anxiety, addiction and suicide) issues than the non-Aboriginal population of youth, which impacts their ability to achieve their educational goals. Understanding mental health from an Aboriginal worldview and through culturally safe strategies designed to translate mental health information to Aboriginal people is lacking. The objectives of the present study were to develop, implement and evaluate a knowledge translation (KT) strategy to enhance wellbeing knowledge and self-efficacy in coping with mental health issues among Aboriginal postsecondary students using a community-based approach. The Tool Development Phase involved focus groups and interviews with Aboriginal post-secondary students (n=9) and community members (n=3) to develop a KT activity. The KT Phase involved a pre/post design where participants (n=4) were asked about their mental health knowledge and self-efficacy in improving their wellbeing prior to and after the KT activity. All students participated in an individual interview one month later about their knowledge and the helpfulness of activity. Key informants (n=4) were interviewed during a Follow-Up and Debriefing phase regarding the community-based approach. Mental health was defined wholistically, as related to community and as being impacted by identity, stigma, cultural connection, intergenerational trauma, and a clash between Aboriginal and positivist Western worldviews. KT preferences included incorporating traditional ceremonies; covering particular topics such as resources, traditional teachings and coping strategies; and incorporating active participation. The KT activity increased knowledge and self-efficacy related to mental health and some knowledge was retained and used at one-month follow-up. As well, participants appreciated the sense of community that the activity created and provided feedback regarding what could be changed (e.g., more active participation). Key informants thought the project addressed some community needs and that it was built on relationships. This study will contribute to increasing the wellbeing of Aboriginal students by expanding upon their mental health knowledge, and sense of self-efficacy in coping with their own mental health issues, with the aim of addressing mental health barriers to the completion of post-secondary education among Aboriginal students.


2021 ◽  
Author(s):  
Caitlin Joy Davey

First Nations, Inuit and Métis youth in Canada report higher rates of mental health (i.e., depression, anxiety, addiction and suicide) issues than the non-Aboriginal population of youth, which impacts their ability to achieve their educational goals. Understanding mental health from an Aboriginal worldview and through culturally safe strategies designed to translate mental health information to Aboriginal people is lacking. The objectives of the present study were to develop, implement and evaluate a knowledge translation (KT) strategy to enhance wellbeing knowledge and self-efficacy in coping with mental health issues among Aboriginal postsecondary students using a community-based approach. The Tool Development Phase involved focus groups and interviews with Aboriginal post-secondary students (n=9) and community members (n=3) to develop a KT activity. The KT Phase involved a pre/post design where participants (n=4) were asked about their mental health knowledge and self-efficacy in improving their wellbeing prior to and after the KT activity. All students participated in an individual interview one month later about their knowledge and the helpfulness of activity. Key informants (n=4) were interviewed during a Follow-Up and Debriefing phase regarding the community-based approach. Mental health was defined wholistically, as related to community and as being impacted by identity, stigma, cultural connection, intergenerational trauma, and a clash between Aboriginal and positivist Western worldviews. KT preferences included incorporating traditional ceremonies; covering particular topics such as resources, traditional teachings and coping strategies; and incorporating active participation. The KT activity increased knowledge and self-efficacy related to mental health and some knowledge was retained and used at one-month follow-up. As well, participants appreciated the sense of community that the activity created and provided feedback regarding what could be changed (e.g., more active participation). Key informants thought the project addressed some community needs and that it was built on relationships. This study will contribute to increasing the wellbeing of Aboriginal students by expanding upon their mental health knowledge, and sense of self-efficacy in coping with their own mental health issues, with the aim of addressing mental health barriers to the completion of post-secondary education among Aboriginal students.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027733 ◽  
Author(s):  
Fernando Lima ◽  
Carrington Shepherd ◽  
Janice Wong ◽  
Melissa O’Donnell ◽  
Rhonda Marriott

ObjectiveThis study examines the scale of maternal mental health related contacts among Australian Aboriginal children over time, and associations with socio-economic characteristics, geographical remoteness and maternal age.DesignA retrospective cohort study of the prevalence of maternal mental health related contacts among Aboriginal children born in Western Australia between 1990 and 2013.SettingPopulation of Western Australia with de-identified linked administrative data from the Western Australian Department of Health.ParticipantsAll Aboriginal children born in Western Australia between 1990 and 2013 and their mothers.Primary outcome measurePrevalence of maternal mental health related contacts among Aboriginal children born between 1990 and 2013. Mental health related contacts were identified using mental health related inpatient hospitalisations and outpatient contacts.ResultsAlmost 30% of cohort children were born to a mother with at least one mental health contact in the 5 years prior to birth, with 15% reported in the year prior to birth and the year post birth. There was a distinct increase in the prevalence of maternal mental health contacts between 1990 and 2013 (4–5% per year, with a peak in 2007). Maternal mental health contacts were associated with living in more disadvantaged areas and major cities, and having a mother aged over 20 years at birth.ConclusionsThe study affirms that mental health issues place a considerable burden on Aboriginal Australia, and suggests that many of the mental health issues that women develop earlier in life are chronic at the time of conception, during pregnancy and at birth. Early intervention and support for women in the earliest stages of family planning are required to alleviate the burden of mental health problems at birth and after birth. There is a clear need for policies on the development of a holistic healthcare model, with a multisector approach, offering culturally appropriate services for Aboriginal people.


2019 ◽  
Vol 27 (3) ◽  
pp. 351-368
Author(s):  
Lorraine Hansford ◽  
Felicity Thomas ◽  
Katrina Wyatt

This paper examines the impact of increased welfare conditionality on people with mental health issues claiming benefits in the UK. Drawing on data from the DeStress study, this paper explores the lived experience of welfare claimants in low-income communities, and the perspectives of GPs seeking to support them. Particular focus is placed on people’s experience of the Work Capability Assessment, the tool used to determine welfare claimants’ entitlement to sickness benefit, and how the narratives and culture surrounding welfare reform and the actual assessment itself can have a negative impact on mental health and wellbeing.


2017 ◽  
Vol 13 (1) ◽  
pp. 61-70 ◽  
Author(s):  
Alberto Ghilardi ◽  
Chiara Buizza ◽  
Egle Miriam Carobbio ◽  
Rossella Lusenti

Background: College counselling can be considered as a front-line service in detecting and managing mental health issues within young adults. In this sense, it is important to investigate the effectiveness of counselling interventions. Objective: To provide a systematic review about college counselling in Italy; to assess which psychological interventions really meet student needs, and their effectiveness; to focus on the level of cohesion between Italian counselling services and the international guidelines about college counselling. Method: A systematic review about college counselling through PsycInfo and PubMed was carried out. Because of the scarceness of pertinent available articles, the survey was extended to Google Scholar and Riviste Web. Keywords: counselling, mental health, wellbeing, psychological support, university, students, Italy. Results: Out of thirty-four articles retrieved, 16 are relevant to academic counselling, the other 18 have been considered not pertinent to the aim of the present review. Data show a lack of homogeneity in methodology and organization between each University: different approaches towards students’ needs. Furthermore, no follow-up studies or measurement of effectiveness were found. Conclusion: This review is a contribution to disseminate the results of counselling experiences in Italy and represents an effort to encourage colleagues working in a web environment to share results and methods for a more organized protocol application.


Sign in / Sign up

Export Citation Format

Share Document