scholarly journals Abortion, substance abuse and mental health in early adulthood: Thirteen-year longitudinal evidence from the United States

2016 ◽  
Vol 4 ◽  
pp. 205031211666599 ◽  
Author(s):  
Donald Paul Sullins
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Disorders ◽  
Confidence Interval ◽  
Pregnancy Outcomes ◽  
Pregnancy Loss ◽  
Early Adulthood ◽  
The United States ◽  
Mental Health Disorder ◽  
Increased Risk

Objective: To examine the links between pregnancy outcomes (birth, abortion, or involuntary pregnancy loss) and mental health outcomes for US women during the transition into adulthood to determine the extent of increased risk, if any, associated with exposure to induced abortion. Method: Panel data on pregnancy history and mental health history for a nationally representative cohort of 8005 women at (average) ages 15, 22, and 28 years from the National Longitudinal Study of Adolescent to Adult Health were examined for risk of depression, anxiety, suicidal ideation, alcohol abuse, drug abuse, cannabis abuse, and nicotine dependence by pregnancy outcome (birth, abortion, and involuntary pregnancy loss). Risk ratios were estimated for time-dynamic outcomes from population-averaged longitudinal logistic and Poisson regression models. Results: After extensive adjustment for confounding, other pregnancy outcomes, and sociodemographic differences, abortion was consistently associated with increased risk of mental health disorder. Overall risk was elevated 45% (risk ratio, 1.45; 95% confidence interval, 1.30–1.62; p < 0.0001). Risk of mental health disorder with pregnancy loss was mixed, but also elevated 24% (risk ratio, 1.24; 95% confidence interval, 1.13–1.37; p < 0.0001) overall. Birth was weakly associated with reduced mental disorders. One-eleventh (8.7%; 95% confidence interval, 6.0–11.3) of the prevalence of mental disorders examined over the period were attributable to abortion. Conclusion: Evidence from the United States confirms previous findings from Norway and New Zealand that, unlike other pregnancy outcomes, abortion is consistently associated with a moderate increase in risk of mental health disorders during late adolescence and early adulthood.

scholarly journals Older Adults in the United States and COVID-19: A Qualitative Study of Perceptions, Finances, Coping, and Emotions

2021 ◽  
Vol 9 ◽  
Author(s):  
R. Turner Goins ◽  
Elizabeth Anderson ◽  
Hannah Minick ◽  
Heather Daniels
Keyword(s):  
Mental Health ◽  
United States ◽  
Older Adults ◽  
News Media ◽  
Emotional Health ◽  
The United States ◽  
Stress Appraisal ◽  
Risk Of Death ◽  
Increased Risk ◽  
Precautionary Measures

Introduction: Older adults have the poorest coronavirus (COVID-19) prognosis with the highest risk of death due to complications, making their COVID-19 experiences particularly important. Guided by the stress-appraisal-coping theoretical model, we sought to understand COVID-related perceptions and behaviors of older adults residing in the United States.Materials and Methods: We used convenience sampling to recruit persons with the following inclusion criteria: Aged ≥ 65 years, English fluency, and U.S. residency. Semi structured in-depth interviews were conducted remotely and audio recorded between April 25, 2020 and May 7, 2020. Interviews were professionally transcribed with a final study sample of 43. A low-inference qualitative descriptive design was used to provide a situated understanding of participants' life experiences using their naturalistic expressions.Results: The mean age of participants was 72.4 ± 6.7. Slightly over half were female (55.8%), 90.6% were White, and 18.6% lived alone. The largest percentages of participants resided in a rural area (27.9%) or small city (25.6%). We identified four themes, including (1) risk perception, (2) financial impact, (3) coping, and (4) emotions. Most participants were aware of their greater risk for poor COVID-19 outcomes but many did not believe in their increased risk. Financial circumstances because of the pandemic varied with largely no financial impacts, while others reported negative impacts and a few reported positive impacts. Coping was problem- and emotion-focused. Problem-focused coping included precautionary efforts and emotion-focused coping included creating daily structure, pursuing new and/or creative activities, connecting with others in new ways, and minimizing news media exposure. Overall, emotional health was negatively affected by the pandemic although some participants reported positive emotional experiences.Conclusions: Perceiving themselves as high risk for COVID-19 complications, older adults used precautionary measures to protect themselves from contracting the virus. The precautionary measures included social isolation, which can negatively affect mental health. Older adults will need to be resourceful and draw on existing resources to cope, such as engaging in creative activities and new strategies to connect with others. Our findings underscore the importance of the preservation of mental health during extended periods of isolation by taking advantage of low-to-no-cost existing resources.

Asthma and Suicidal Ideation Among Youth in the Community

Crisis ◽  
2004 ◽  
Vol 25 (3) ◽  
pp. 99-102 ◽  
Author(s):  
Renee D. Goodwin ◽  
Andrej Marušič
Keyword(s):  
Mental Health ◽  
United States ◽  
Suicidal Ideation ◽  
Mental Disorders ◽  
The United States ◽  
Sociodemographic Characteristics ◽  
Multiple Logistic Regression ◽  
Regression Analyses ◽  
Community Based ◽  
Comorbid Mental Disorders

Summary: Objective: To determine the association between asthma and suicidal ideation among youth in the community. Method: Data were drawn from the MECA (n = 1285), a community-based study of youth aged 9-17 in the United States. Multiple logistic regression analyses were used to determine the association between asthma and suicidal ideation, adjusting for differences in sociodemographic characteristics and mental disorders. Results: Asthma was associated with a significantly increased likelihood of suicidal ideation (OR = 3.25 ‘1.04, 10.1’), compared to youth without asthma. Conclusions: These data suggest that youth who are hospitalized for asthma may have higher than expected levels of suicidal ideation, compared with youth without asthma in the community. This association appears to persist after controlling for the effects of comorbid mental disorders. These findings are consistent with previous clinical reports of an association between physical illness and suicidal ideation, as well as with links between asthma and suicidal ideation among adults. More in-depth evaluation of the mental health of youth hospitalized for asthma may be indicated if these results are replicated.

Research Domain Criteria and OCD

2017 ◽  
Author(s):  
Eyal Kalanthroff ◽  
Gideon E. Anholt ◽  
Helen Blair Simpson
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Disorders ◽  
The United States ◽  
Self Report ◽  
Research Domain Criteria ◽  
Diagnostic Systems ◽  
Behavioral Measures ◽  
Research Domain

This chapter discusses the Research Domain Criteria (RDoC) project, an initiative of the National Institutes of Mental Health (NIMH) of the United States to develop for research purposes new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures, and explores how the hallmark symptoms of OCD (obsessions, compulsions, and anxiety) can be mapped onto RDoC domains. Unlike current categorical diagnostic systems (e.g., DSM), RDoC seeks to integrate many levels of information (from genomics to self-report) to validate dimensions defined by neurobiology and behavioral measures that cut across current disorder categories. The chapter explores, for heuristic reasons, how the RDoC matrix might be used to elucidate the neurobehavioral domains of dysfunction that lead to the characteristic symptoms of OCD. It then selectively reviews the OCD literature from the perspective of the RDoC domains, aiming to guide future transdiagnostic studies to examine specific neurobehavioral domains across disorders.

A brief history of the criminalization of mental illness

CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 638-650 ◽  
Author(s):  
Joel A. Dvoskin ◽  
James L. Knoll ◽  
Mollie Silva
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Illness ◽  
Community Mental Health ◽  
Mental Disorders ◽  
The United States ◽  
Mental Illnesses ◽  
The People ◽  
History Of ◽  
Serious Mental Illnesses

This article traces the history of the way in which mental disorders were viewed and treated, from before the birth of Christ to the present day. Special attention is paid to the process of deinstitutionalization in the United States and the failure to create an adequately robust community mental health system to care for the people who, in a previous era, might have experienced lifelong hospitalization. As a result, far too many people with serious mental illnesses are living in jails and prisons that are ill-suited and unprepared to meet their needs.

Race and Cancer-Associated Venous Thromboembolism in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3551-3551
Author(s):  
Daniel Douce ◽  
Nels Olson ◽  
Mary Cushman ◽  
Pamela L Lutsey ◽  
Suzanne Judd ◽  
...  
Keyword(s):  
United States ◽  
Venous Thromboembolism ◽  
Confidence Interval ◽  
Trauma Surgery ◽  
The United States ◽  
Southeastern Us ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Male Sex ◽  
Blacks And Whites

Abstract Introduction: Venous thromboembolism (VTE) is classified as provoked (associated with surgery, hospitalization, trauma, or cancer) and unprovoked events. Whether provoked, unprovoked or cancer-associated VTE differs by age, sex, race, or region in the United States is poorly understood. Methods: VTE events were ascertained in 30,183 individuals in the REGARDS cohort enrolled between 2003-2007 in the contiguous United States. Participants were enrolled in their homes, with a goal of 50% of the cohort being black, female, and living in the southeastern US. VTE events were identified by telephone interviews, review of hospitalizations and deaths and validated by physician review of medical records. Cancer-associated VTE (CA-VTE) was defined as a VTE associated with active cancer or chemotherapy in the last 90 days. Non-cancer, provoked VTE was defined as a VTE that was preceded within 90 days by major trauma, surgery, or hospitalization. Unprovoked VTE was defined as having none of the above risk factors. The associations of age, sex, race and region with cancer-associated, provoked, and unprovoked VTE were analyzed by chi square analyses and Cox proportional hazard ratios that were adjusted for age, sex, race, region and obesity. Results: Overall, 332 VTE events occurred over a mean of 4.7 years follow up. Of these, 163 events (49.1%) were provoked, 47 (14.2%) were CA-VTE. The proportion of unprovoked to provoked VTE did not differ by age (120 to 104 in those older than 65, 49 to 59 for those under 65, p=0.16) sex (98 to 90 in men, 71 to 73 in women, p=0.61), race (61 to 62 in blacks, 108 to 101 in whites, p=0.71) or region (89 to 88 in the Southeast, 80 to 75 for the rest of the country p=0.81); however CA-VTE was significantly less common in blacks (11 of 123, 8.9%) than whites (36 of 209, 17.2%) (p=0.04). While the overall risk of VTE was similar in blacks and whites, blacks had a lower risk of CA-VTE than whites (Hazard Ratio (HR) 0.38, 95% Confidence Interval (CI) 0.18-0.77). Increased age and male sex were associated with an increased risk for all-cause VTE and unprovoked VTE with a trend for male sex and increased risk for provoked VTE (Table). However, men had no increased risk of CA-VTE compared to women (0.85 95% CI 0.46-1.55). Discussion: The proportion of provoked versus unprovoked VTE events did not differ by age, sex, race or region in REGARDS, though blacks had a lower proportion of CA-VTE than whites. Men overall had a higher risk of VTE than women, but there was no increased risk for CA-VTE in men. Blacks and whites had a similar risk of VTE overall, however blacks had a lower incidence of CA-VTE than whites. Possible reasons for our findings include shorter survival after a diagnosis of cancer, different cancer types or treatments, or differential ascertainment of VTE by race or sex. These findings highlight the need to understand how sex and race impact VTE incidence so we can best prevent VTE in everyone. Table. Hazard Ratios for different VTE subtypes by Age, Sex, and Race (95% Confidence Interval) All VTE Unprovoked VTE Provoked VTE Cancer-Associated VTE Age (per SD, 9.4 years) 1.61 (1.43-1.80) 1.70 (1.44-1.99) 1.52 (1.29-1.79) 1.48 (1.09-2.02) Male Sex 1.42 (1.13-1.78) 1.52 (1.11-2.09) 1.32 (0.96-1.82) 0.85 (0.47-1.55) Black versus White Race 0.90 (0.71-1.13) 0.84 (0.61-1.16) 0.96 (0.69-1.34) 0.38 (0.18-0.77) Disclosures No relevant conflicts of interest to declare.

scholarly journals Early initiation of prophylactic anticoagulation for prevention of coronavirus disease 2019 mortality in patients admitted to hospital in the United States: cohort study

BMJ ◽  
2021 ◽  
pp. n311
Author(s):  
Christopher T Rentsch ◽  
Joshua A Beckman ◽  
Laurie Tomlinson ◽  
Walid F Gellad ◽  
Charles Alcorn ◽  
...  
Keyword(s):  
United States ◽  
Cohort Study ◽  
Confidence Interval ◽  
Hospital Admission ◽  
The United States ◽  
Early Initiation ◽  
Inpatient Mortality ◽  
Therapeutic Anticoagulation ◽  
Increased Risk ◽  
Prophylactic Anticoagulation

Abstract Objective To evaluate whether early initiation of prophylactic anticoagulation compared with no anticoagulation was associated with decreased risk of death among patients admitted to hospital with coronavirus disease 2019 (covid-19) in the United States. Design Observational cohort study. Setting Nationwide cohort of patients receiving care in the Department of Veterans Affairs, a large integrated national healthcare system. Participants All 4297 patients admitted to hospital from 1 March to 31 July 2020 with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and without a history of anticoagulation. Main outcome measures The main outcome was 30 day mortality. Secondary outcomes were inpatient mortality, initiating therapeutic anticoagulation (a proxy for clinical deterioration, including thromboembolic events), and bleeding that required transfusion. Results Of 4297 patients admitted to hospital with covid-19, 3627 (84.4%) received prophylactic anticoagulation within 24 hours of admission. More than 99% (n=3600) of treated patients received subcutaneous heparin or enoxaparin. 622 deaths occurred within 30 days of hospital admission, 513 among those who received prophylactic anticoagulation. Most deaths (510/622, 82%) occurred during hospital stay. Using inverse probability of treatment weighted analyses, the cumulative incidence of mortality at 30 days was 14.3% (95% confidence interval 13.1% to 15.5%) among those who received prophylactic anticoagulation and 18.7% (15.1% to 22.9%) among those who did not. Compared with patients who did not receive prophylactic anticoagulation, those who did had a 27% decreased risk for 30 day mortality (hazard ratio 0.73, 95% confidence interval 0.66 to 0.81). Similar associations were found for inpatient mortality and initiation of therapeutic anticoagulation. Receipt of prophylactic anticoagulation was not associated with increased risk of bleeding that required transfusion (hazard ratio 0.87, 0.71 to 1.05). Quantitative bias analysis showed that results were robust to unmeasured confounding (e-value lower 95% confidence interval 1.77 for 30 day mortality). Results persisted in several sensitivity analyses. Conclusions Early initiation of prophylactic anticoagulation compared with no anticoagulation among patients admitted to hospital with covid-19 was associated with a decreased risk of 30 day mortality and no increased risk of serious bleeding events. These findings provide strong real world evidence to support guidelines recommending the use of prophylactic anticoagulation as initial treatment for patients with covid-19 on hospital admission.

scholarly journals Early Intervention in Schools: Recommendations for Enhanced Psychological Services

2019 ◽  
Vol 2 (4) ◽  
pp. 94-95
Author(s):  
Mignone Theresa ◽  
◽  
Klostermann Keith ◽  
Mahadeo Melissa ◽  
◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Early Intervention ◽  
Mental Disorder ◽  
The United States ◽  
Mental Health Disorder ◽  
Psychological Services ◽  
Childhood And Adolescence

Childhood and adolescence are times of adjusting to change and increasing demands in one’s life. As such, it is perhaps not surprising that in the United States alone, approximately 13% to 20% of children experience a mental disorder each year, or that 20% of adolescents experience a diagnosable mental health disorder.

scholarly journals What To Expect When You’re No Longer Expecting: How States Use Concealment and Abuse of a Corpse Statutes Against Women

2021 ◽  
Vol 40 (2) ◽  
pp. 167-205
Author(s):  
Nisha Chandra
Keyword(s):  
United States ◽  
Pregnancy Outcomes ◽  
Women Of Color ◽  
Pregnancy Loss ◽  
The United States ◽  
Medical Services ◽  
Reproductive Justice ◽  
Chilling Effect ◽  
Poor Women ◽  
Fetal Personhood

Since the 1690s, women in the United States have been arrested and punished for experiencing miscarriages and stillbirths—pregnancy outcomes that are completely normal. This practice continues to the modern day, where prosecutors charge women with concealing a birth, concealing a death, or abuse of a corpse for the actions they take after experiencing pregnancy loss. This Note argues that these statutes were originally enacted to punish women who had sex outside of marriage and are now being used to control women, mostly women of color and poor women, for not adhering to society’s idealized vision of femininity and motherhood. The use of these statutes advances notions of fetal personhood and will ultimately have a chilling effect on the availability of abortion through telemedicine. The Note suggests that while repealing these laws would help, the best solution is to approach the issue through a reproductive justice lens—namely, increasing the availability of education and medical services for women.

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