scholarly journals Targeted provider education and pre-visit planning increase rates of formal depression screening in childhood-onset SLE

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Evan Mulvihill ◽  
Rebecca Furru ◽  
Alanna Goldstein-Leever ◽  
Kyla Driest ◽  
Stephanie Lemle ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Lupus Erythematosus ◽  
Health Resources ◽  
Depression Screening ◽  
Screening Methods ◽  
Provider Education ◽  
Clinical Workflow ◽  
Childhood Onset ◽  
Self Harm

Abstract Background Despite being at high risk for depression, patients with childhood-onset systemic lupus erythematosus (c-SLE) are infrequently and inconsistently screened for depression by their pediatric rheumatologists. We aimed to systematically increase rates of formal depression screening for c-SLE patients in an academic Pediatric Rheumatology clinic. Methods Our multi-disciplinary quality improvement (QI) team used electronic health record (EHR) documentation to retroactively calculate baseline rates of documented depression screening using the Patient Health Questionnaire-9 (PHQ-9). We then engaged key stakeholders to develop a clinical workflow for formal depression screening in the clinic. We also provided education to providers regarding mental health disorders in c-SLE, with an emphasis on prevalence, screening methods, and management of positive screens. We then used the Plan-Do-Study Act (PDSA) method of QI to systematically evaluate and adjust our process in real time. The primary outcome was the percentage of patients with c-SLE seen per month who had a documented PHQ-9 screening within the past year. Results The percentage of children with documented PHQ-9 results ranged from 0 to 4.5 % at baseline to 91.0 % within 12 months of project initiation. By the end of the project, monthly screening rates greater than 80 % has been sustained for 10 months. As a result of these efforts, twenty-seven (48.2 %) patients with at least mild depressive symptoms were identified while seven (12.5 %) with thoughts of self-harm were referred to appropriate mental health resources. Conclusions Routine formal depression screening is feasible in a busy subspecialty clinic. Using QI methods, rates of formal depression screening among children with c-SLE were increased from an average of 3.3 % per month to a sustained monthly rate of greater than 80 %. Individuals with depressive symptoms and/or thoughts of self-harm were identified and referred to appropriate mental health resources.

scholarly journals Changes in millennial adolescent mental health and health-related behaviours over 10 years: a population cohort comparison study

2019 ◽  
Vol 48 (5) ◽  
pp. 1650-1664 ◽  
Author(s):  
Praveetha Patalay ◽  
Suzanne H Gage
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Depressive Symptoms ◽  
Mental Health Problems ◽  
Poor Mental Health ◽  
Poor Sleep ◽  
Birth Cohorts ◽  
Health Related ◽  
Self Harm ◽  
Social Behaviours

Abstract Background There is evidence that mental health problems are increasing and substance use behaviours are decreasing. This paper aimed to investigate recent trends in mental ill health and health-related behaviours in two cohorts of UK adolescents in 2005 and 2015. Methods Prevalences in mental health (depressive symptoms, self-harm, anti-social behaviours, parent-reported difficulties) and health-related behaviours (substance use, weight, weight perception, sleep, sexual intercourse) were examined at age 14 in two UK birth cohorts; Avon Longitudinal Study of Parents and Children (ALSPAC, N = 5627, born 1991–92) and Millennium Cohort Study (MCS, N = 11 318, born 2000–02). Prevalences and trend estimates are presented unadjusted and using propensity score matching and entropy balancing to account for differences between samples. Results Depressive symptoms (9% to 14.8%) and self-harm (11.8% to 14.4%) were higher in 2015 compared with 2005. Parent-reported emotional difficulties, conduct problems, hyperactivity and peer problems were higher in 2015 compared with 2005 (5.7–8.9% to 9.7–17.7%). Conversely, substance use (tried smoking, 9.2% to 2.9%; tried alcohol, 52.1% to 43.5%, cannabis, 4.6% to 3.9%), sexual activity (2% to 0.9%) and anti-social behaviours (6.2–40.1% to 1.6–27.7%) were less common or no different. Adolescents in 2015 were spending less time sleeping (<8 h 5.7% to 11.5%), had higher body mass index (BMI) (obese, 3.8% to 7.3%) and a greater proportion perceived themselves as overweight (26.5% to 32.9%). The findings should be interpreted bearing in mind limitations in ability to adequately harmonize certain variables and account for differences in attrition rates and generalizability of the two cohorts. Conclusions Given health-related behaviours are often cited as risk factors for poor mental health, our findings suggest relationships between these factors might be more complex and dynamic in nature than currently understood. Substantial increases in mental health difficulties, BMI and poor sleep-related behaviours highlight an increasing public health challenge.

Depressive symptoms are prevalent in childhood-onset systemic lupus erythematosus (cSLE)

Lupus ◽  
2013 ◽  
Vol 22 (7) ◽  
pp. 712-720 ◽  
Author(s):  
S Ahola Kohut ◽  
TS Williams ◽  
J Jayanthikumar ◽  
C Landolt-Marticorena ◽  
A Lefebvre ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Depressive Symptoms ◽  
Lupus Erythematosus ◽  
Childhood Onset ◽  
Systemic Lupus ◽  
Onset Systemic Lupus Erythematosus

scholarly journals The Impact of Social Media Platforms on Self-Injurious Behavior in Adolescents

2019 ◽  
Vol 27 (3) ◽  
pp. 156-174
Author(s):  
N.A. Polskaya ◽  
D.K. Yakubovskaya
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Resources ◽  
Well Being ◽  
Global Challenge ◽  
Self Injury ◽  
Social Media Platforms ◽  
Self Harm ◽  
The Impact ◽  
To Receive

The paper provides a review of studies on non-suicidal self-injury (NSSI) in online social networking. Content characteristics of online self-injury narrative are examined by focusing on such categories as hashtags, images, and comments. Negative and positive aspects of social networks’ impact on the risk of self-injury in adolescent are summarized. The presence of NSSI content online and the ability to communicate on issues relating to self-injury can either improve psychological well-being of the users by increasing their mood and self-acceptance, giving means to receive support from others and get information on mental health resources, or increase the person’s susceptibility to self-injuries by initiating their interest in this subject and reinforcing, and encouraging repeated self-harm. Therefore, mental health professionals are facing a global challenge: to create supportive and helpful online content, which implies the development of a new methodology, including language and terminology, that could integrate existing online discourse on self-injury and transform it from within.

scholarly journals Depression and self-harm from adolescence to young adulthood in sexual minorities compared with heterosexuals in the UK: a population-based cohort study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Irish ◽  
F Solmi ◽  
B Mars ◽  
M King ◽  
G Lewis ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Young Adulthood ◽  
Sexual Minority ◽  
Sexual Minorities ◽  
Multilevel Models ◽  
Mental Health Problems ◽  
Population Based ◽  
Minority Adolescents ◽  
Self Harm

Abstract Background There are few population-based cohort studies of the emergence, development, and persistence of mental health problems in sexual minorities compared with heterosexuals. We compared trajectories of depressive symptoms in sexual-minority adolescents and heterosexual adolescents from when they were aged 10 to 21 years, and examined self-harm at ages 16 and 21 years. Methods The study included 4828 adolescents born between April 1, 1991, and Dec 31, 1992, from the Avon Longitudinal Study of Parents and Children birth cohort (Bristol, UK) who reported their sexual orientation when aged 16 years. Depressive symptoms were assessed with the short Mood and Feelings Questionnaire at seven timepoints between ages 10 and 21 years. A self-harm questionnaire was completed at ages 16 and 21 years. Analyses were linear multilevel models with growth curves (depressive symptoms), logistic multilevel models (self-harm in the previous year at ages 16 and 21 years), and multinomial regression (lifetime self-harm with and without suicidal intent at age 21 years). Findings At age 10, depressive symptoms were higher in sexual minorities than in heterosexuals and increased with age to a larger extent. Depressive symptoms increased at each timepoint by 0·31 points in hetereosexuals, and by 0·49 points in sexual minorities. Sexual-minority adolescents were more likely than heterosexual adolescents to report self-harm in the previous year at ages 16 and 21 years, with no evidence that this estimate decreased with age. At aged 21, sexual minorities were more likely to report lifetime self-harm (ie, on at least one previous occasion) with suicidal intent than heterosexuals. Interpretation Mental health disparities between heterosexuals and sexual minorities are present early in adolescence and increase throughout the school years, persisting to young adulthood. Prevention of these mental health problems and early intervention must be a priority.

scholarly journals FEASIBILITY OF SCREENING AND MANAGING CAREGIVER BURDEN AND DEPRESSIVE SYMPTOMS DURING PATIENTS’ CLINIC VISITS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S767-S767
Author(s):  
Ranak Trivedi ◽  
Rashmi Risbud ◽  
Manali Patel ◽  
Steven Asch ◽  
Karl Lorenz
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Caregiver Burden ◽  
Short Form ◽  
Health Resources ◽  
Clinical Psychologist ◽  
Counseling Session ◽  
Brief Counseling ◽  
Cancer Caregivers ◽  
Clinic Visits

Abstract Half of cancer caregivers experience depression, caregiver burden, or stress, yet less than a third have discussed their needs with anyone. Identifying this vulnerable population is challenging since caregivers only interact with the healthcare system in service of the patients. Our objectives were: 1) To test the feasibility of screening cancer caregivers for burden and depressive symptoms during patients’ clinic visits; and 2) To test the feasibility of a brief counseling session for caregivers who screened positive for either. Caregivers of patients with head and neck cancers were recruited from cancer clinic waiting rooms at Palo Alto VA and Stanford. Caregivers completed the PHQ-9 (depressive symptoms), and Zarit Burden Inventory-Short Form (caregiver burden). Participants screening positive for burden (>16) and/or depressive symptoms (>9) were provided psychoeducational resources and the choice to attend 1 brief counseling session with a clinical psychologist. Of the 50 participants who completed the surveys, 36 (72%) were women and 30 (60%) were significant others. Mean scores for depressive symptoms and caregiver burden were 6.29±5.01 and 11.02±8.62, respectively. Twenty participants screened positive for depressive symptoms (n=9) or caregiver burden (n=11); 3 screened positive for both. Of those who screened positive, only 4 indicated an interest in counseling. Main reason for refusal was lack of time, or that they were already receiving mental health care. Screening caregivers at patient visits is feasible and convenient. However, connecting those in need to mental health resources may be more challenging.

scholarly journals An audit of risk assessments and management for self-harm and suicide in patients with depressive symptoms at a primary care practice in the UK

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S89-S89
Author(s):  
Win Let Oo
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Primary Care Practice ◽  
Significant Risk ◽  
Care Practice ◽  
Nice Guidelines ◽  
Increased Risk ◽  
Self Harm ◽  
The Impact

AimsOver 5 million adults in England are living with depression, with the highest prevalence rates recorded in the North West and North East of England, 12.88% and 11.53%, respectively (NHS Digital, 2019). Depression is also associated with the highest rates of self-harm and suicide (SH&S) (Singhal, Ross, Seminog, Hawton, & Goldarce, 2014). The impact of SH&S on a family ranges from shock and horror to, blame, secrecy and shame. Survivors may also be negatively judged or self-stigmatise (Cerel, Jordan, & Duberstein, 2008). Managing self-harm episodes has a significant financial implication for the NHS (Tsiachristas, et al., 2017). If high-risk individuals are identified and intervened early, it would not only save lives but also potentially reduce financial strains. The aim of the audit is to evaluate the performance of risk assessment and management of self-harm and suicide at the Reedyford Healthcare Group, Nelson, England, and to determine whether the primary care practice is meeting the standards of the National Institute for Health and Care Excellence (NICE) guidelines for adults with depression.MethodA retrospective audit of 62 patients presenting with depressive symptoms over 3 months was performed at the Reedyford Healthcare Group.Two criteria from the NICE guidelines for adults with depression were included with associated standards of 100%:All patients with depression should be assessed for suicidal ideation and intent by asking direct questions.A patient presenting with significant risk to self/others should be referred to specialist mental health services the same day, as soon as possible.Result42 patients were asked direct questions about SH&S. 2 patients presenting with immediate risk were urgently referred to specialist services. Nonetheless, all those patients at increased risk of suicide were given an increased level of support by the practice. The results indicated that the practice could improve, and a quality improvement approach has been planned.ConclusionThe assessment of risk in patients presenting with depression is vital. This audit shows that it is not always done in practice. The author has not found other published audits on this topic and suggests that this may be appropriate for a national audit. This is particularly prudent with the current concern regarding mental health in the COVID-19 pandemic.

scholarly journals Correction to: Targeted provider education and pre-visit planning increase rates of formal depression screening in childhood-onset SLE

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Evan Mulvihill ◽  
Rebecca Furru ◽  
Alana Goldstein-Leever ◽  
Kyla Driest ◽  
Stephanie Lemle ◽  
...  
Keyword(s):  
Depression Screening ◽  
Provider Education ◽  
Childhood Onset

scholarly journals Prognostic evaluation of suicidality and development of risk factors in victims of physical and emotional child abuse and emotional/psychological neglect

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S273-S273
Author(s):  
Latif Miah
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Child Abuse ◽  
Depressive Symptoms ◽  
Suicidal Ideation ◽  
Child Maltreatment ◽  
Health Issue ◽  
Public Health Issue ◽  
Self Harm ◽  
The Impact

AimsTo evaluate the effects of childhood maltreatment, specifically physical and emotional abuse and emotional/psychological neglect on the development of suicidal ideation, depressive symptoms and self-harm. It is hypothesised that there will be a strong causal link between the aforementioned types of maltreatment with suicidality, depression and self-harm.BackgroundChild abuse is a major public health issue with profound developmental and mental health consequences towards victims and their contributions to society as a whole. The impact of sexual abuse is well-established, however non-sexual child maltreatment and its sequelae are not as well understood or studied.MethodA literature search was carried out using the Pubmed, Cochrane, Scopus and Google Scholar databases. Articles were appraised according to set criteria and manually screened for relevance to the review.ResultThe results of this review demonstrate that there are statistically significant, potentially causal links between emotional and physical abuse, and emotional/psychological neglect with suicidal ideation, depressive symptoms and self-harm. More research is still required to elucidate the role of polyvictimisation in mental health outcomes and to further confirm these links between abuse and development.ConclusionChild maltreatment remains a large public health issue with major impact on the economy of the world. It has profound, potentially lifelong consequences on victims and is something that needs to lose its stigma so that it can be identified earlier and potential damage prevented as far as possible. The future may lie in working to remove the stigma surrounding it, standardise how it is studied and thus learn to recognise the signs earlier – ideally leading to implementation of policy to get victims to safety, preventing unncecessary harm.

scholarly journals Pre-conception self-harm, maternal mental health and mother–infant bonding problems: a 20-year prospective cohort study

2018 ◽  
Vol 49 (16) ◽  
pp. 2727-2735 ◽  
Author(s):  
Rohan Borschmann ◽  
Emma Molyneaux ◽  
Elizabeth Spry ◽  
Paul Moran ◽  
Louise M. Howard ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Depressive Symptoms ◽  
Young Adulthood ◽  
Maternal Mental Health ◽  
Depression Scale ◽  
Time Points ◽  
Perinatal Depressive Symptoms ◽  
Self Harm ◽  
Health Cohort Study

AbstractBackgroundSelf-harm in young people is associated with later problems in social and emotional development. However, it is unknown whether self-harm in young women continues to be a marker of vulnerability on becoming a parent. This study prospectively describes the associations between pre-conception self-harm, maternal depressive symptoms and mother–infant bonding problems.MethodsThe Victorian Intergenerational Health Cohort Study (VIHCS) is a follow-up to the Victorian Adolescent Health Cohort Study (VAHCS) in Australia. Socio-demographic and health variables were assessed at 10 time-points (waves) from ages 14 to 35, including self-reported self-harm at waves 3–9. VIHCS enrolment began in 2006 (when participants were aged 28–29 years), by contacting VAHCS women every 6 months to identify pregnancies over a 7-year period. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale during the third trimester, and 2 and 12 months postpartum. Mother–infant bonding problems were assessed with the Postpartum Bonding Questionnaire at 2 and 12 months postpartum.ResultsFive hundred sixty-four pregnancies from 384 women were included. One in 10 women (9.7%) reported pre-conception self-harm. Women who reported self-harming in young adulthood (ages 20–29) reported higher levels of perinatal depressive symptoms and mother–infant bonding problems at all perinatal time points [perinatal depressive symptoms adjusted β = 5.40, 95% confidence interval (CI) 3.42–7.39; mother–infant bonding problems adjusted β = 7.51, 95% CI 3.09–11.92]. There was no evidence that self-harm in adolescence (ages 15–17) was associated with either perinatal outcome.ConclusionsSelf-harm during young adulthood may be an indicator of future vulnerability to perinatal mental health and mother–infant bonding problems.

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